The Detroit Free Press on Tuesday examined the declining percentage of women in the U.S. who are receiving mammograms annually and the reasons for the decline. According to the Free Press, mammography rates "steadily" increased in the 1990s. However, National Committee on Quality Assurance statistics show that the percentage of women who had commercial health insurance and received a mammogram dropped from 75.3% in 2003 to 73.4% in 2004. The mammography rate for Medicaid beneficiaries decreased from 55.9% to 54% over the same period, and rates have "leveled off but not improved among Medicare recipients," according to the Free Press. Some experts have said the drop in mammography rates could be because of an increase in the number of women who do not have health insurance; higher copayments for office visits; inconsistent findings from studies on the effectiveness of mammograms in preventing breast cancer deaths; news reports about the decreasing mortality rate of breast cancer; and a lack of emphasis on mammography in advertising campaigns, the Free Press reports. Some health insurance plans, including the Priority Health and Health Alliance Plan of Michigan, have launched programs to increase mammography rates, including giving bonuses to doctors with the highest annual mammogram rates among their patients and giving gift certificates to women who receive mammograms (Anstett, Detroit Free Press, 5/23).

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